What Do You Do After You've Climbed The Mountain?

Greetings from the banks of the River Severn.

It's nearly five years since I started the journey to reverse Type 2 Diabetes. I've had some tough days, particularly in the covid months.

Since then, I've had thousands of messages from people who are also struggling to lose weight and stay healthy. I'm asked for advice and tips every day. When all the gyms had closed, I decided to write it all down in another book. It's published on 23rd June.

The team at Kyle books tell me that pre-orders are a massive deal. It feels the same postal votes were in my last job! Friends can help me by pre-ordering the book on Amazon. Please will you pre-order The Book?

Can you imagine the pressure of writing a book called Lose Weight 4 Life? What a rod for the back that is! Where Downsizing was an eating memoir, Lose weight 4 Life is a blueprint of how you can turn things around.

In today's newsletter, I've written about what it's like to have a setback after health success? Does it resonate with your experiences? I'd love to know your views.

Thanks, Tom

Where it began 

I cried when the GP revealed the blood test result proving I'd reversed Type 2 diabetes in 2017. So rare was it to reverse the condition that Dr Nazeer, my GP, gave me a little half-hug. It felt like I'd climbed to the peak of a mountain. Thankfully, I am still Type 2 free nearly five years later. Still, it's been a struggle, especially as I have had to cope with unexpected stresses which have tested and occasionally beaten my resolve: moving house, the pandemic, and most of all, the death of my father last year.

But however difficult life is, you cannot give up on controlling a chronic condition like Type 2 diabetes. A report from the University of Cambridge has just revealed that middle-aged health problems, from cancer, macular degeneration in the eye and heart conditions start five years earlier in those with Type 2.

Good news, at last

Indeed irreversible damage can occur before diagnosis. So it was good news this week that an NHS early intervention - The Diabetes Prevention Programme – seems to be working. The programme cleverly identifies those most at risk of developing the illness and then puts them on a nine-month plan to change their lifestyles. According to researchers at the University of Manchester, 18,000 fewer people in England were diagnosed with Type 2 diabetes between 2018 and 2019 – a 7% reduction.

But what happens when you’ve lost weight?

But it's still fair to say one of the most challenging issues with type 2 is not prevention or even that initial success in controlling it - it's what happens afterwards that matters most. Type 2 is not a broken leg that is good as new once healed. This is an ongoing battle to keep your weight at a healthy level through good nutrition and regular exercise. It's a lifelong commitment.
No wonder then - that for a brief time in 2017, that mountain peak was a joy as I cast a contemptuous eye over the foothills of my former life of late-night political intrigue and fast-food fueled campaign visits.
It had been a relief to leave the artery-hardening stress of dealing with the likes of trades unionist Len McCluskey. Yet when I stood down as an MP in 2019, I didn't have a job and didn't have a plan. I'd not thought about what I was giving up – a close and supportive group of friends and colleagues, and all those painfully worked out routines and habits; the external scaffolding required to traverse the many demands of a health journey fell apart.
My morning routine had been robust: weigh-in, monitor blood pressure, brew coffee, take blood sugar and blood ketone levels, trainers on for a run. The practice had been the axle of my daily life, but it collapsed when I left Westminster. I'd got everything just right in my Westminster flat– gym kit in precisely the right drawer, the gratitude journal opened on the right page on my desk.

Change always brings certain losses and only possible gain

But my new home in Worcestershire didn't have a place to store my two bikes. Those hard-won habits – so regular they'd become unconscious behaviours, disappeared. I was starting again in a shared house of demanding teenagers; God bless them. Don't get me wrong, I don't mind them "borrowing" the batteries from the kitchen scales to replace the empty ones in the X-box controller, but it was another new hurdle.
So in hindsight, I should have known that I'd not reached a peak but a plateau. I had more mountains to climb to maintain good health: Covid, three lockdowns, and family bereavement hit me hard. In November 2020, I was running five kilometres nearly every day. I'm not sure if I even walked 5k in a single day the following November.

Whatever happens, no matter how bad it gets, don’t go back to sugar

Yet even with these exercise setbacks, I still maintained a diet of nutritionally dense food. I no longer test my blood sugars every day, but I occasionally wear a Continuous Glucose Monitor (CGM) to make sure they're still in a healthy range. For Type 2 diabetics, how high your blood sugar spikes is essential to know. Using a CGM is how I learnt that a lockdown dalliance with homemade sourdough bread was not a good idea. The spike on the CGM was just too high for too long for me to continue perfecting the art of baking.
Of course, I knew that if I returned to the bad old ways of sweets, beer and sleep deprivation, my blood sugar levels would creep back up, and I'd be ill again. Yet a hastily assembled home office less than 10 feet away from the fridge brought fresh challenges. I'd stupidly interviewed cheesemonger extraordinaire Ned Palmer for my 'Persons of Interest' podcast. Ned's enthusiasm for cheese is catchy. Before long, I was ordering Mrs Kirkham's Lancashire cheese by the truckle load. Even though I've not scoffed at a KitKat for more than four years, devouring chunks of cheese, micro-sliver by micro-sliver, takes its toll on the waistline.
For the first time in three years, my weight started to creep up, just when all the gyms shut their doors. Luckily for me, I found a copy of Dr Jen Unwin's book, Fork in the Road, about carbohydrate and sugar addiction.

When it goes wrong, deconstruct where the failure happens

Now I understood what was happening. Whilst Percy Pigs are dead to me, and I no longer steal my children's Easter eggs (I describe myself as a reformed sugar addict), Dr Unwin explained that it is not unusual for her patients to replace sugar with cheese as their addiction!
Initially, I got my health back by significantly reducing carbohydrates from my diet. But many people who have stunning weight loss success on keto, or very low carbohydrate diets, often stall when they become too reliant on dairy products. Keto advocates are happy to have mugs of coffee topped up with cream. Before long, you can end up swilling it directly from the plastic pot. And even though keto dieters are not obsessed with calorie counting, calories still matter.
Having made the connection, I reminded myself just why I had worked so hard to lose weight in the first place: it's hard to describe just how much I don't want to be 22 stones again. It would be humiliating to put myself back on the High and Mighty triple XL mailing list. So when the gyms re-opened and I cancelled the cheese subscriptions, everything was back on track.

Sometimes the cosmos delivers you setbacks you can’t control

Then in 2021, a much more difficult challenge came: dad died. After years of health challenges and setbacks, his heart finally gave way. He had type 2 diabetes, and by the time we lost him, he was using insulin. Though we knew he was in poor health, his death still came as a great shock.
Grief is all-consuming, and it makes you hungry. In five years, it's the nearest I've come to returning to uncontrolled eating. My gym attendance stalled, and I started picking smarties from the tops of Colin the caterpillar cakes again. These vulgar indiscretions were barely noticeable to others, but they were a regression, and the lack of control played with my head.

To lose weight 4 life, you need a reset plan

I had to refocus and reset the plan. So after fits and starts between lockdowns, my reset plan began in earnest at the beginning of February. And that's where things stand today. The batteries have been replaced in the scales (last week down a kilogram). I have a daily steps target (10k a day but averaging 12k). I lift weights three times a week. I log my food on the MyFitness pal app and try to close all the rings on my apple watch. The gamification of health data helps me maintain focus.
What's the lesson of all of this? If you're losing weight for life or reversing Type 2 diabetes, you have to think about maintenance. It requires a mindset that encourages you to adopt habits when your circumstances change. You need a reset programme when things inevitably go awry. Measuring your progress and gains over time helps embed your successes.
I think it helps to remember that, like Sisyphus, you will be pushing the boulder up your mountain eternally. But you can learn to enjoy it - and most of all, remember what a privilege it is to be alive.